A Study to Compare High Versus Low Bicarbonate Bath in Critically-ill Patients Receiving Continuous Renal Replacement Therapy


About this study

The purpose of this study is to investigate the effect of using high versus low bicarbonate containing replacement fluid in patients with metabolic acidosis receiving continuous renal replacement therapy (CRRT) with veno-venous hemofiltration (CVVH) for acute kidney injury (AKI) on in-hospital mortality.

Participation eligibility

Participant eligibility includes age, gender, type and stage of disease, and previous treatments or health concerns. Guidelines differ from study to study, and identify who can or cannot participate. If you need assistance understanding the eligibility criteria, please contact the study team.

Inclusion Criteria:

  • Adult patients (≥ 18 years of age).
  • Ability to obtain informed consent, either from patient or legally authorized representative (LAR).
  • Diagnosis of AKI according to KDIGO definition [an increase in serum creatinine concentration of greater than or equal to 0.3 mg/dL within the first 48 hours of injury, a relative increase in serum creatinine of greater than or equal to 50% (1.5-fold from baseline) within the first 7 days of injury, or a reduction in urine output (< 0.5 mL/kg/h for more than 6 hours)].
  • CRRT initiated for the first time during current ICU admission.
  • Bicarbonate ≤ 22 mEq/L.
  • Arterial pH between 7.05 and 7.25 (if an ABG is not available, venous pH must be between 7.00 and 7.20).

Exclusion Criteria:

  • Pregnancy (women of child-bearing potential must have a negative pregnancy test).
  • Diagnosis of End-Stage renal disease and receiving Hemodialysis or peritoneal dialysis prior to ICU admission (this information will be easily obtained by the nephrology team), or have received renal replacement therapy (either HD or CRRT) during the current hospital admission.
  • Arterial pH < 7.05 or > 7.25 (if an ABG is not available, Venous pH  < 7.00 or > 7.20).
  • Potassium level >6.0 mmol/L.
  • Severe acute liver failure meeting any of the following criteria:
    • INR > 2;
    • AST > 500 U/L;
    • ALT > 500 U/L;
    • Bilirubin > 12 mg/dL.
  • Previous enrollment in this study.



Participating Mayo Clinic locations

Study statuses change often. Please contact us for help.

Mayo Clinic Location Status Contact

Rochester, Minn.

Mayo Clinic principal investigator

Kianoush Kashani, M.D., M.S.

Open for enrollment

Contact information:

Laurie Meade R.N.



More information


Publications are currently not available

Study Results Summary

Not yet available

Supplemental Study Information

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